Active NPI
Tracie Fried
- Pharmacist
- Park Ridge, NJ
National Provider Identifier
1003424540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 28RI02499000
- Practice address
- 40 Park Ave
Park Ridge, NJ 07656-1240 - Phone
- (201) 554-2200
- NPI assigned
- Jul 21, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28RI02499000 | NJ | Primary |
Addresses
Primary practice location
40 Park Ave
Park Ridge, NJ 07656-1240
Mailing address
285 Fern St
Township of Washington, NJ 07676-5024
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28RI02499000 | NJ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Blooming Health LLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Park Ridge, NJ
- NPI 1194367987
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1595289600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595289600000",
"number": "1003424540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "285 FERN ST",
"city": "TOWNSHIP OF WASHINGTON",
"state": "NJ",
"postal_code": "076765024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "40 PARK AVE",
"city": "PARK RIDGE",
"state": "NJ",
"postal_code": "076561240",
"telephone_number": "201-554-2200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FRIED",
"first_name": "TRACIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-07-21",
"last_updated": "2020-07-21",
"certification_date": "2020-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NJ",
"license": "28RI02499000",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park Ridge, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.